Adam Lanza shot his mother, a teacher, in the face, and then drove her car to the school where she worked. He then shot and killed 28 people, mostly children. His girlfriend and another friend are missing. Folks are wondering why this happened. Why shoot the children? It all ended with Lanza killing himself at the scene of his murderous rampage.

As a Psychiatric RN for many years I can perhaps help you to understand why things got to this point. Adam Lanza was a 20 year old who likely had severe character disorder, ADD, possibly autism per the brother’s report. He also reportedly had anger management problems. I am betting that he also used drugs recreationally, could not hold down a job, and was enabled by his parents to live at home with only time on his hands. He was probably a former Special Education student and, as is usually the case, learned to manipulate adults due to his ADD. I can imagine Adam’s parents had unending difficulties in trying to handle a child like him, and unfortunately the mental health system does not lock up anyone until there is violence on the part of the child. Insurance companies are not covering mental health services for children like they used to.

When I was going through my divorce, I wanted to get my own son counseling and despite having private insurance it was still very difficult. In my situation at the time, my child was not talking about the divorce or his feelings and I only wanted to make sure he was adjusting. Thank God, my son was not having major mental issues or behavioral problems; there is a shortage of facilities where I live and I have heard horror stories of parents driving hundreds of miles in California to have their suicidal child evaluated. Unfortunately there are very few children’s Inpatient facilities in my state.

I will give you another reason for these murders: suicidality. If someone, anyone, is suicidal, they may not want to go out alone. As we used to say in the nursing profession, if they are suicidal, they could very easily become homicidal. Suicidal thoughts resulting from untreated depression do not make one rational. If someone is showing signs of depression and making suicidal statements, I believe it is very prudent to make the assumption they could become a killer. What would they have to lose?

I am going to take a big leap here and say that the missing friend and girlfriend will also be found dead. I’m purely speculating, but perhaps Adam Lanza’s mother may have seen signs of the murders; she may have noticed strange behavior or blood and may have tried to ascertain what happened. If he was suicidal from those acts, it is very likely he became enraged and shot his mother when she confronted him or tried to call police. My guess is that they will find drugs or alcohol in his blood, but if drugs or alcohol weren’t used, it may have simply been a case of Adam’s untreated anger problems that escalated into violence. I have treated “screamers” who threw things and some who become so angry they are literally blinded by the rage. I am very positive Lanza likely did not have any means of dealing with his anger in any healthy way. His coping skills had probably been poor since early childhood. He probably had no ability to deal with frustration. To keep things simple, he probably had a very short fuse and no ability to think outside of the present moment.

These are all presumptions on my part due to many years of experience. Perhaps the parents were fatigued from dealing with 20 years of Adam’s problems. “Burnt out” is what we call it. Families can become totally burnt by one sick, needy, family member, especially when any ‘help’ is very hard to get even with good private insurance. They can become numb to the symptoms and behaviors.

Some folks call it evil. I am sure Adam’s parents never imagined his violent rages would escalate to the point of killing 20 children, and 7 adults. No one ever wants to think these things are possible, but they should—and it should make every parent think twice when they are seeing behavior that alarms them.

I don’t want to entirely blame the parents but if I knew my son had problems and was living with me in my home, I would have locked my gun up. If those guns had been in a safe, all of these tragedies would have been averted. I am very much pro-guns in the right hands; but if someone has problems in my home, precautions would have been in place.

None of what Adam did will make sense. Why did he drive to the school and shoot innocent children? Perhaps after murdering the first few people he became totally irrational and his unconscious anger led him to the place where his rejection and failure all started: school. We cannot ever know, now that he is dead. But from my experience he likely did not perform well at school, and was likely ridiculed there which did not help his mental and emotional state.

This was a horrible tragedy for all of Adam Lanza’s victims but I believe future mass murders are preventable. So what should we do in the future?

First, every community should have good mental health services for children and adults. This did not happen overnight. With Lanza, I am sure there were teachers, neighbors, and/or childhood friends who all saw signs of future violence. This is merely a case of someone who likely made threats but no one took them seriously. He was probably someone who was less enraged when under the influence, but which unfortunately lowered the threshold for acting-out behaviors.

Next, teachers need to be trained to notice signs of depression and suicidal behavior.

We also need to teach parents when to seek professional help and ensure that professional help is truly available.

Last, every community should have child protective services with mobile evaluation teams to respond when the community needs it.

In our modern day society, these tragedies are going to become more and more prevalent due to lack of cohesive family units. There is also lack of other family generational involvement. Both parents need to work to support a family. I realize working parents are fatigued from all the pressures of this cold and uncaring society and workforce and lifestyle and it is hard to do the right thing when you are in a chronic state of exhaustion, like many families are. There are fragmented families, and uneducated “baby Mommas”, and the mentality is that “the school will deal with my kid.” I really hate to say it, but I think there could potentially be a lot more Adam Lanza’s, especially in light of the fact that Obamacare will be deciding who gets treatment. I really hope I am wrong. But with services already stretched to the max, I cannot see them having much hope for treatment, or professional help in the future.

As an RN, the best advice I can give is if you love someone and they are suffering from depression, coping problems, drug or alcohol abuse, please take it seriously! It will not get better all by itself—and if they have other diagnoses (i.e. ADD) or a history of violence it is just a matter of time before they explode. With help and treatment there can be hope; otherwise a tragedy like Newtown is a possible scenario.

Meanwhile in Newtown, Connecticut, the surviving children and their parents will never be the same. I am saddened for the victims and their loved ones but this never has to happen again if cautionary steps are taken, and help is received before it is too late.